The Centers for Medicare & Medicaid Services (CMS) has finalized a 2026 Physician Fee Schedule that keeps much of today’s telehealth access in place for another year, while setting a firm deadline for some of the most widely used pandemic-era flexibilities.
The move gives providers until December 31, 2026, to keep billing a broad range of virtual services, including from non-facility locations. But starting January 1, 2027, audio-only visits will no longer be covered under Medicare Part B, and clinicians will need to return to facility-based originating sites to bill most telehealth services, according to agency guidance.
Industry observers describe the rule as a mixed bag: it expands the menu of covered services and keeps video-based care widely available, yet it pulls back on tools that helped reach patients without reliable broadband or devices.
What’s extended and expanded
CMS is adding new services to the Medicare Telehealth List for 2026, including 18 codes tied to behavioral health and remote patient monitoring. The additions aim to shore up access for mental health and chronic disease management, areas where telehealth use has remained strong since the pandemic.
The agency also removes certain geographic constraints for specific telehealth services, allowing more care to be delivered regardless of whether a beneficiary lives in a rural or urban area. Rural health clinics and federally qualified health centers retain expanded options to serve patients virtually, according to agency materials.
Clinicians will be able to continue providing and billing telehealth from outside traditional medical facilities through 2026 a carryover from COVID-era flexibilities that providers say helped stabilize access and staffing.
CMS officials framed the package as a balance between maintaining access and tightening standards. While we extend flexibilities to support access through 2026, these changes ensure telehealth’s long-term sustainability by focusing on high-quality, video-based care that meets clinical standards, a CMS spokesperson said in a statement.
What ends after 2026
The biggest change arrives in 2027. CMS will stop reimbursing audio-only evaluation and management visits, which surged during the pandemic. Clinicians will also need to originate telehealth services from approved medical facilities to bill Medicare, ending the home-based billing option popular with after-hours and specialty providers.
Advocates warn that ending audio-only coverage could widen access gaps for older adults and low-income beneficiaries who lack video capability. This is a step forward with new codes, but ending audio-only is a setback for rural patients without reliable broadband, the American Telemedicine Association said, urging Congress to consider permanent parity for certain services.
Impact on skilled nursing
For skilled nursing facilities (SNFs), inpatient telehealth options remain available, which providers say is critical for timely consults and preventing unnecessary transfers. But restrictions tied to post-acute transitions and audio-only visits could complicate discharge planning and routine follow-ups, especially in buildings where residents often rely on staff devices or telephone-only connections.
LeadingAge, which represents nonprofit aging services providers, said preserving inpatient telehealth is essential, but warned that new limits could push readmissions higher if facilities can’t reliably connect residents via video.
Claims hold adds near-term disruption
In a separate development, CMS has instructed Medicare Administrative Contractors to temporarily hold certain telehealth claims dated on or after October 1, 2025, amid federal funding uncertainty, according to industry guidance. Providers report delays of 60 to 90 days in some cases, a cash-flow hit that physician groups say comes on top of inflation and staffing pressures.
The claim holds amid the shutdown are unacceptable; they’re delaying critical payments to physicians already under strain, the American Medical Association said in a statement, while supporting the additions to covered telehealth services.
By the numbers
The rule affects more than 65 million Medicare beneficiaries. CMS projects savings of roughly $1.2 billion in 2026 tied to curbing overuse and tightening coverage for certain modalities. Industry estimates suggest delayed payments could touch billions in annual telehealth reimbursements if claim holds persist.
What providers should do now
Operators are being advised to update billing systems and workflows for the 2026 code changes, invest in reliable video platforms, and prepare residents and families for a potential shift away from audio-only options. SNFs, in particular, may need to bolster on-site technology and staff training to sustain virtual behavioral health and specialty care, which many facilities credit with lowering avoidable hospital trips.
Provider groups say the next year will be crucial. Extensions through 2026 offer breathing room, but without further action from Congress, the 2027 changes could force a rapid pivot to facility-based, video-only telehealth. For long-term care operators, that may mean new costs, tighter scheduling, and a renewed emphasis on hybrid models that blend in-person and virtual care.
